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超声引导下妊娠囊内注射甲氨蝶呤治疗宫颈妊娠:一例报告

Treatment of Cervical Pregnancy with Ultrasound-Guided Intragestational Injection of Methotrexate: A Case Report.

作者信息

Rouvali Angeliki, Vlastarakos Panagiotis, Stavros Sofoklis, Giourga Maria, Pappa Kalliopi, Gerede Angeliki, Rodolakis Alexandros, Domali Ekaterini

机构信息

1st Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Department of Obstetrics and Gynecology Democritus, University of Thrace Alexandroupolis, Greece.

出版信息

Case Rep Obstet Gynecol. 2021 Nov 10;2021:6601461. doi: 10.1155/2021/6601461. eCollection 2021.

Abstract

This study is aimed at describing a noninvasive conservative strategy to the treatment of cervical pregnancy and highlighting the success of ultrasound-guided therapeutic techniques. A 43-year-old woman with a history of one previous cesarean section presented in our unit with vaginal spotting and a positive urine pregnancy test. She was diagnosed with a cervical pregnancy, and she was successfully treated conservatively with the administration of intragestational sac methotrexate under ultrasound guidance. Cervical pregnancy is a rare form of ectopic pregnancy that results from conceptus implantation in the cervical canal. The main concern is the associated life-threatening hemorrhage and subsequent need for urgent hysterectomy. The evolution of ultrasound over the past decades has enabled early diagnosis and has shifted the management from a radical surgical approach towards a stepwise conservative therapeutic approach, when possible.

摘要

本研究旨在描述一种治疗宫颈妊娠的非侵入性保守策略,并强调超声引导治疗技术的成功。一名有一次剖宫产史的43岁女性因阴道点滴出血和尿妊娠试验阳性就诊于我院。她被诊断为宫颈妊娠,并在超声引导下通过向妊娠囊内注射甲氨蝶呤成功进行了保守治疗。宫颈妊娠是一种罕见的异位妊娠形式,由孕卵植入宫颈管引起。主要问题是可能出现危及生命的出血以及随后需要紧急子宫切除术。在过去几十年中,超声技术的发展使得早期诊断成为可能,并在可能的情况下将治疗方式从根治性手术方法转变为逐步保守治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bb5/8598359/c33e007c0ecf/CRIOG2021-6601461.001.jpg

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